ChoicePA Registration Instructions July 2014 Prior Authorization of Outpatient Specialized Therapies North Carolina Division of Medical Assistance
Introduction The Carolinas Center for Medical Excellence (CCME) conducts prior authorization (PA) reviews for the North Carolina Division of Medical Assistance (DMA) for outpatient specialized therapy treatment. PA is needed for treatment visits when provided in all settings except hospital/rehabilitation inpatient settings or when provided by a Local Education Agency following the Individualized Education Program process. Prior Authorization is required for all Health Choice and Medicaid beneficiaries except for those who are also Medicare beneficiaries. Outpatient specialized therapies include: Audiology Occupational Therapy Physical Therapy Respiratory Therapy Speech Language Pathology Additional information about outpatient specialized therapies can be found on the DMA website and in Clinical Coverage Policies 10A through 10D: http://www.ncdhhs.gov/dma/mp/. DMA requires electronic submission of PA requests through CCME s ChoicePA web portal. Using ChoicePA, providers can also: Track the status of requests Respond to requests for additional information View/print notification letters For additional help, please contact CCME via: Telephone 800-228-3365 Email priorauth@thecarolinascenter.org Registration Instructions NC DMA July 2014 1
Setting up an Account/Registration I. USER ROLES AND PERMISSIONS You must register as either a ChoicePA Administrator (Admin) or a User. The ChoicePA Admin is responsible for managing other users within the ChoicePA website, i.e., assigning user permissions and inactivating accounts. This person does not need to be an administrator in the organization. Each provider (NPI) must have at least one registered ChoicePA Admin before other users may register. ChoicePA allows a maximum of two Admin accounts per NPI. In addition to the roles of Admin and User, ChoicePA allows a third role of Supervisor. An Admin may promote a user to the role of Supervisor or Admin. A Supervisor can also manage users and may promote a user to the role of Supervisor. Users access to requests will be limited to those they create, but they may be granted additional permissions by an Admin or Supervisor to view and access requests created by other users associated with the same NPI. Functions vary by user role as represented in the following table: User Supervisor Admin Create Requests and Edit, View, Submit and/or Delete these requests Edit/View/Submit/Delete requests created for your NPI by other users Based on permissions* Based on permissions* All requests Update account/contact information Change password and security question Associate additional provider with account Grant permission for enhanced access (assign Service Types) Promote user/supervisor Create/edit the provider PIN Inactivate user accounts *Permissions: Users will always have access to requests they initiated, regardless of the therapy type. For access to requests created by other users, enhanced permissions are needed. Supervisors and Admins can permit other users to see all requests for specified therapies (Service Type), regardless of who created the request. For example, a user granted access to Physical Therapy (PT) will have access to all PT requests for the specific NPI number in addition to any request they initiated. Supervisors can only grant access to therapy cases to which they have access. Registration Instructions NC DMA July 2014 2
II. ADMINISTRATOR ACCOUNT (ADMIN) Before you begin, you will need: Provider NPI Provider Tax ID Valid taxonomy and ZIP code for NPI Your old CCME generated PIN (if previously registered with CCME) 1. Click the Create an account! link. Providers may designate any personnel as a ChoicePA Admin, but each NPI is limited to two Admins. At least one Admin must be registered before other users may register. For enhanced security, providers are advised to set up two Admin accounts even for single practitioner entities. 2. Enter your Provider NPI, select Administrator under Account Type. Then click on the Begin Registration button. You will be alerted if the NPI cannot be validated. 3. On the next page, enter the needed information for the Provider, Contact, and User Account Information sections. Registration Instructions NC DMA July 2014 3
Required fields are marked with a red asterisk*. An email address can be associated with only one account, but you may associate multiple NPIs with a single account. This allows individuals working for multiple providers with different NPIs to maintain a single username and password for log in. You will be alerted if the username already exists in ChoicePA and must select another to create your account. (Usernames will display in ChoicePA reports.) If prompted, select the option that best describes the professional makeup of your Provider Group. Registration Instructions NC DMA July 2014 4
4. Create a Provider Identification Number (PIN). The Admin must share this PIN with other users for their successful registration. Only the first Admin to register will create a PIN. The second Admin to register can view the PIN after logging in to ChoicePA; either Admin can change the provider PIN. For security reasons, the PIN displays as asterisks (****). Click Show PIN to view the characters entered. 5. Review the Terms of Use and mark the box to indicate agreement with the terms. Select the Submit Registration button. You may also cancel the registration or start the registration process over again. Congratulations, you have now set up your Admin account and can log in to ChoicePA. III. USER ACCOUNT Before you begin, you will need: NPI and PIN (provided by designated ChoicePA Admin). 1. Click the Create an account! link. Registration Instructions NC DMA July 2014 5
2. Enter your Provider NPI, select User under Account Type. Then select the Begin Registration button. Note: You will be alerted if the NPI cannot be validated. 3. On the next page, enter the PIN and complete Contact Information and User Account sections. Registration Instructions NC DMA July 2014 6
For security reasons, the PIN is displayed as asterisks (****). Click Show PIN to view the characters entered. 4. Review the Terms of Use and mark the box to indicate agreement with the terms. Select the Submit Registration button. Congratulations, you have now set up your User account and can log in to ChoicePA. Registration Instructions NC DMA July 2014 7